New Reimbursement Codes Effective April 2004 Broaden Access for Breast Cancer Patients
ALPHARETTA, Ga.--(BUSINESS WIRE)--April 12, 2004-- Proxima Therapeutics, Inc. today announced that the Centers for Medicare and Medicaid Services (CMS) has assigned new Healthcare Common Procedure Coding System (HCPCS) codes for placement of its MammoSite balloon catheter. The codes, C9714 and C9715, will be used by hospitals to report the placement of a balloon catheter into the breast for interstitial radiation therapy, either at the time of lumpectomy or in a separate procedure, respectively. The new technology payment categories assigned by CMS include the cost of the MammoSite device and will provide appropriate reimbursement for hospitals that offer the procedure, effective April 1, 2004. MammoSite is a proprietary balloon catheter that facilitates the delivery of partial breast irradiation, the emerging practice of delivering radiation only to the tissue where cancer is most likely to recur while minimizing the exposure of healthy tissue. The device enables physicians to deliver an entire course of radiation from inside the breast over a five-day period. MammoSite is the most widely used partial breast irradiation treatment in the world, and since its clearance by the FDA in May 2002, has been used to treat thousands of early-stage breast cancer patients at more than 400 U.S. hospitals and treatment centers.
A study published in the Journal of the National Cancer Institute found that, over the course of five years, partial breast irradiation produces comparable results to whole-breast radiation therapy in preventing breast cancer recurrence in women with early-stage breast cancer who are treated with breast-conserving therapy.
"We are extremely pleased that CMS has assigned these new codes for MammoSite, ensuring that patients will have increased access to this breast cancer treatment," said Timothy Patrick, president and chief executive officer of Proxima Therapeutics, Inc. "MammoSite has been widely adopted already because it is a targeted treatment that offers women an option that easily fits into their lifestyles and minimizes unnecessary radiation exposure to healthy breast tissue and organs such as the heart and lungs. We expect this code to increase adoption by permitting appropriate payment and simplifying the reimbursement process for both hospitals and breast cancer patients."
The announcement by CMS should also permit more appropriate payment systems to be developed for non-Medicare patients. Private payer systems commonly establish reimbursement levels based upon Medicare codes and payment rates. Prior to the assignment of the new codes, hospitals have relied on other general codes to claim reimbursement.
The MammoSite device is a minimally invasive balloon catheter that is inserted into the cavity created by a lumpectomy. During a five-day course of therapy, a tiny radioactive seed attached to a wire is inserted into the balloon, delivering prescribed levels of radiation under precise computer control to the targeted tissue surrounding the cavity. No source of radiation remains in the patient's body between treatments or after the final procedure. For a list of treatment centers, refer to www.mammosite.com.
Safety and performance of MammoSite for delivery of internal radiation were evaluated in a multi-center study, which involved women with early-stage breast cancer. The results of the study were published in the International Journal of Radiation Oncology*Biology*Physics (February 2003).
About Proxima Therapeutics
Based in Alpharetta, Ga., Proxima Therapeutics, Inc. is a privately held medical device company established in 1995 to develop site-specific cancer treatment systems for breast and brain tumors. Products include GliaSite RTS for brain cancer and MammoSite RTS for breast cancer. Additional information is available on the company's Web site at http://www.proximatherapeutics.com. Physicians and patients may call 1-86-MAMMOSITE (1-866-266-6748) for more information.
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Source: Proxima Therapeutics, Inc.